16 research outputs found
Reliability of a novel electro-medical device for wheal size measurement in allergy skin testing: An exploratory clinical trial
Skin prick testing (SPT) is the cornerstone of IgE-mediated allergy diagnosis,1 due to its high sensitivity and specificity.2 However, a uniform method for wheal measurement does not exist. Ansotegui et al.2 recommends to measure wheals in millimeters with a ruler, in many centers they are outlined with a pen and transfer by tape to a paper and then measured. Subsequently, the specialist is able to manually measure the maximum (MD) and orthogonal diameter (OD) of the wheal. This procedure is time consuming and makes repro-ducible measurements difficult.2,3 Knowing the wheal's area could help make a more accurate diagnosis.4 Over the last 30 years, many attempts have been made to develop a device to measure the size of SPT.3 Nexkin DSPTÂź (Figure S1A,B) is a novel mechatronic system based on 3D laser technology, that automatically locates allergen's wheal and measures its size (MD, OD and area in square millimeters) (Figure S1C)
Identification of a novel locus on chromosome 2q13, which predisposes to clinical vertebral fractures independently of bone density.
OBJECTIVES: To identify genetic determinants of susceptibility to clinical vertebral fractures, which is an important complication of osteoporosis. METHODS: Here we conduct a genome-wide association study in 1553 postmenopausal women with clinical vertebral fractures and 4340 controls, with a two-stage replication involving 1028 cases and 3762 controls. Potentially causal variants were identified using expression quantitative trait loci (eQTL) data from transiliac bone biopsies and bioinformatic studies. RESULTS: A locus tagged by rs10190845 was identified on chromosome 2q13, which was significantly associated with clinical vertebral fracture (P=1.04Ă10-9) with a large effect size (OR 1.74, 95%âCI 1.06 to 2.6). Bioinformatic analysis of this locus identified several potentially functional SNPs that are associated with expression of the positional candidate genes TTL (tubulin tyrosine ligase) and SLC20A1 (solute carrier family 20 member 1). Three other suggestive loci were identified on chromosomes 1p31, 11q12 and 15q11. All these loci were novel and had not previously been associated with bone mineral density or clinical fractures. CONCLUSION: We have identified a novel genetic variant that is associated with clinical vertebral fractures by mechanisms that are independent of BMD. Further studies are now in progress to validate this association and evaluate the underlying mechanism
Adjuvants for allergy immunotherapeutics
Allergic diseases are reaching epidemic proportions in developed countries. In particular, food allergy is increasing in prevalence and severity, thus becoming an important socioeconomic burden. Numerous cell types and cell populations, which form an intricate and balanced network, are involved in an immune response. This balance is occasionally disturbed, leading to the onset of different diseases, such as allergic diseases. Antihistamines and corticosteroids provide some degree of relief from the symptoms of allergic conditions. However, the only treatment that can revert the disease is immunotherapy. Nevertheless, specific immunotherapy has at least 2 major drawbacks: it is time-consuming, and it can produce local and even systemic allergic side effects. Immunotherapy's potential goes beyond our current knowledge of the immune response; nevertheless, we can still design strategies to reach a safer immune modulation for treating allergies. This review deals with the use of adjuvants to reduce the undesirable side effects associated with specific allergen immunotherapy. For example, nanoparticles used as immunoadjuvants are offering promising results in preclinical assays
Is the performance of ImmunoCAP ISAC 112 sufficient to diagnose peach and apple allergies?
On a celluloid platter An analysis of the representations and functions of food and eating in the cinema
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Validation of novel recipes for masking peanuts in double-blind, placebo-controlled food challenges
Background: Double-blind, placebo-controlled oral food challenges are the gold standard in food allergy
diagnosis. Nevertheless, proper masking of peanuts is particularly complex owing to their intense flavor
and odor. Thus, it is important to use validated recipes to ensure their adequate masking during oral food
challenges.
Objective: To design and validate recipes containing masked peanuts for double-blind, placebo-controlled oral
food challenges.
Methods: Two types of products (cookies and a custardâtype dessert) containing the masked peanuts and other
ingredients with low allergenic potential were designed and validated. For this purpose, of the 24 initial cookie
recipes and 12 initial custard recipes developed, those that did not exhibit significant differences in their texture
were selected for sensory validation.
Results: Similarity triangle tests were performed using a panel of 36 selected tasters, enabling the validation of 1
pair of cookie recipes and 1 pair of custard-type dessert recipe, both with low allergenic potential and suitable
for those with celiac disease and for vegans.
Conclusion: The validated recipes are of clinical and research interest because they allow to confirm a peanut
allergy and detect a wide range of tolerated threshold doses, which makes it possible to provide specific indica-
tions for each patient
Improvement of the Elevated Tryptase Criterion to Discriminate IgE- From NonâIgE-Mediated Allergic Reactions
BACKGROUND: Differentiating between immunoglobulin E (IgE)-dependent and IgE-independent
hypersensitivity reactions may improve the etiologic orientation and clinical management of
patients with allergic reactions in the anesthesia setting. Serum tryptase levels may be useful
to discriminate the immune mechanism of allergic reactions, but the diagnostic accuracy and
optimal cutpoint remain unclear.
We aimed to compare the diagnostic accuracy of tryptase during reaction (TDR) alone and the
TDR/basal tryptase (TDR/BT) ratio for discriminating IgE- from nonâIgE-mediated allergic reac-
tions, and to estimate the best cut point for these indicators.
METHODS: We included 111 patients (45% men; aged 3â99 years) who had experienced an
allergic reaction, even though the allergic reaction could be nonanaphylactic. Allergy tests were
performed to classify the reaction as an IgE- or nonâIgE-mediated one. The area under the curve
(AUC) of the receiver operating characteristic analysis was performed to estimate the discrimi-
native ability of TDR and TDR/BT ratio.
RESULTS: An IgE-mediated reaction was diagnosed in 49.5% of patients, of whom 56% met ana-
phylaxis criteria. The median (quartiles) TDR for the IgE-mediated reactions was 8.0 (4.9â19.6)
and 5.1 (3.5â8.1) for the nonâIgE-mediated (P = .022). The median (quartiles) TDR/BT ratio
was 2.7 (1.7â4.5) in IgE-mediated and 1.1 (1.0â1.6) in nonâIgE-mediated reactions (P < .001).
The TDR/BT ratio showed the greatest ability to discriminate IgE- from nonâIgE-mediated reac-
tions compared to TDR (AUC TDR/BT = 0.79 [95% confidence interval (CI), 1.1â2.2] and AUC
TDR = 0.66 [95% CI, 1.1â2.2]; P = .003). The optimal cut point for TDR/BT (maximization of the
sum of the sensitivity and specificity) was 1.66 (95% CI, 1.1â2.2).
CONCLUSIONS: The TDR/BT ratio showed a significantly better discriminative ability than TDR
to discriminate IgE- from nonâIgE-mediated allergic reactions. An optimal TDR/BT ratio thresh-
old of approximately 1.66 may be useful in clinical practice to classify allergic reactions as IgE-
or nonâIgE-mediated. (Anesth Analg 2018;127:414â9
Validation of a commercial allergen microarray platform for specific immunoglobulin E detection of respiratory and plant food allergens
Background
As the use of multiplex-specific immunoglobulin E (sIgE) detection methods becomes increasingly widespread, proper comparative validation assessments of emerging new platforms are vital.
Objective
To evaluate the clinical and technical performance of a newly introduced microarray platform, Allergy Explorer (ALEX) (MacroArray Diagnostics), in the diagnosis of pollen (cypress, grass, olive), dust mite (Dermatophagoides pteronyssinus), mold (Alternaria alternata), fruit (apple, peach), and nut (walnut, hazelnut and peanut) allergies and to compare it with those of the ImmunoCAP Immuno Solid-phase Allergen Chip (ISAC) 112 microarray and the ImmunoCAP singleplex method (ThermoFisher Scientific).
Methods
We enrolled 153 patients with allergy and 16 controls without atopy. The sIgE assays were conducted using ISAC112, ALEX version 2 (ALEX2), and ImmunoCAP for whole extracts and major components. Technical validation of ALEX2 was performed by measuring repeatability and interassay, interbatch, and interlaboratory reproducibility.
Results
When measured globally (detection by 1 or more allergen components), ALEX2 had adequate sensitivity and specificity for most of the allergens studied, comparable in general with that of ISAC112 (except for olive pollen and walnut) and similar to that of ImmunoCAP whole extract measurements. Component-by-component analysis revealed comparable results for all techniques, except for Ole e 1 and Jug r 3, in both ISAC112 and ImmunoCAP comparisons, and Alt a 1, when compared with ISAC112. Continuous sIgE levels correlate with sIgE by ImmunoCAP. Good reproducibility and repeatability were observed for ALEX2.
Conclusion
ALEX2 has sound technical performance and adequate diagnostic capacity, comparable in general with that of ISAC112 and ImmunoCAP
Validation of a commercial allergen microarray platform for specific immunoglobulin E detection of respiratory and plant food allergens - Improvement of the Elevated Tryptase Criterion to Discriminate IgE- From NonâIgE-Mediated Allergic Reactions - Validation of novel recipes for masking peanuts in double-blind, placebo-controlled food challenges
Background: As the use of multiplex-specific immunoglobulin E (sIgE) detection methods becomes increasingly
widespread, proper comparative validation assessments of emerging new platforms are vital.
Objective: To evaluate the clinical and technical performance of a newly introduced microarray platform, Allergy
Explorer (ALEX) (MacroArray Diagnostics), in the diagnosis of pollen (cypress, grass, olive), dust mite (Dermato-
phagoides pteronyssinus), mold (Alternaria alternata), fruit (apple, peach), and nut (walnut, hazelnut and peanut)
allergies and to compare it with those of the ImmunoCAP Immuno Solid-phase Allergen Chip (ISAC) 112 microar-
ray and the ImmunoCAP singleplex method (ThermoFisher Scientific).
Methods: We enrolled 153 patients with allergy and 16 controls without atopy. The sIgE assays were conducted using
ISAC112, ALEX version 2 (ALEX2), and ImmunoCAP for whole extracts and major components. Technical validation of
ALEX2 was performed by measuring repeatability and interassay, interbatch, and interlaboratory reproducibility.
Results: When measured globally (detection by 1 or more allergen components), ALEX2 had adequate sensitivity
and specificity for most of the allergens studied, comparable in general with that of ISAC112 (except for olive pol-
len and walnut) and similar to that of ImmunoCAP whole extract measurements. Component-by-component
analysis revealed comparable results for all techniques, except for Ole e 1 and Jug r 3, in both ISAC112 and Immu-
noCAP comparisons, and Alt a 1, when compared with ISAC112. Continuous sIgE levels correlate with sIgE by
ImmunoCAP. Good reproducibility and repeatability were observed for ALEX2.
Conclusion: ALEX2 has sound technical performance and adequate diagnostic capacity, comparable in general
with that of ISAC112 and ImmunoCAP
Improvement of the elevated tryptase criterion to discriminate IgE- from non-IgE-mediated allergic reactions
BACKGROUND: Differentiating between immunoglobulin E (IgE)-dependent and IgE-independent
hypersensitivity reactions may improve the etiologic orientation and clinical management of
patients with allergic reactions in the anesthesia setting. Serum tryptase levels may be useful
to discriminate the immune mechanism of allergic reactions, but the diagnostic accuracy and
optimal cutpoint remain unclear.
We aimed to compare the diagnostic accuracy of tryptase during reaction (TDR) alone and the
TDR/basal tryptase (TDR/BT) ratio for discriminating IgE- from nonâIgE-mediated allergic reactions, and to estimate the best cut point for these indicators.
METHODS: We included 111 patients (45% men; aged 3â99 years) who had experienced an
allergic reaction, even though the allergic reaction could be nonanaphylactic. Allergy tests were
performed to classify the reaction as an IgE- or nonâIgE-mediated one. The area under the curve
(AUC) of the receiver operating characteristic analysis was performed to estimate the discriminative ability of TDR and TDR/BT ratio.
RESULTS: An IgE-mediated reaction was diagnosed in 49.5% of patients, of whom 56% met anaphylaxis criteria. The median (quartiles) TDR for the IgE-mediated reactions was 8.0 (4.9â19.6)
and 5.1 (3.5â8.1) for the nonâIgE-mediated (P = .022). The median (quartiles) TDR/BT ratio
was 2.7 (1.7â4.5) in IgE-mediated and 1.1 (1.0â1.6) in nonâIgE-mediated reactions (P < .001).
The TDR/BT ratio showed the greatest ability to discriminate IgE- from nonâIgE-mediated reactions compared to TDR (AUC TDR/BT = 0.79 [95% confidence interval (CI), 1.1â2.2] and AUC
TDR = 0.66 [95% CI, 1.1â2.2]; P = .003). The optimal cut point for TDR/BT (maximization of the
sum of the sensitivity and specificity) was 1.66 (95% CI, 1.1â2.2).
CONCLUSIONS: The TDR/BT ratio showed a significantly better discriminative ability than TDR
to discriminate IgE- from nonâIgE-mediated allergic reactions. An optimal TDR/BT ratio threshold of approximately 1.66 may be useful in clinical practice to classify allergic reactions as IgEor nonâIgE-mediated. (Anesth Analg 2018;127:414â9